Though the lobby of the new Spirit Lake Veterans Affairs Clinic was standing room only for its mid-October ribbon cutting, several northwest Iowa legislators were unable to attend. U.S. Rep. Steve King circled back to the VA facility last week to tour the building and speak with the clinic staff.

“Of course, I like what I see,” King said. “One of the things that stands out that I want to express to people is the dedication of the staff here at the VA clinic. It’s a labor of love and such an example of dedication.”

The new facility is located near the corner of Highway 9 and Royal Avenue in Spirit Lake — part of the area dubbed Berkley Place — and houses eight exam rooms, four consolation rooms and two telehealth rooms. The rooms are arranged around the providers’ central office in what Clinic Manager Angie Cook described as a stage-on-stage-off care model. The patients are generally able to stay in the same room during the entire appointment while providers come and go.

“The veterans are the host, instead of the other way around,” King said.

The clinic’s two telehealth rooms allow veterans to speak and even be examined to a degree by physicians across the country. Cook said the imagery is so clear dermatologists can diagnose skin rashes via telehealth. She said the clinic set up its first telehealth dental appointment the morning of King’s visit.

“The telehealth piece of it is something I didn’t expect to see developed out to the level it is,” King said, adding the method would have been considered too impersonal in decades past. “We’ve got a lot more experience with it now, and people are getting acclimated to it.”

Similarly, the clinic is also able to care for patients in a 60-mile radius through its Home Base program. In some cases, staff members draw blood, set up medication and do physical assessments with a provider remotely present on a mobile device.

“A couple other places, I think, are going to start that, but we kind of piloted that here,” Cook said. “It’s gone very well.”

All in all, the local clinic serves between 2,200 and 2,400 veterans in a 10-county area. Cook estimated anywhere from 60 to 100 patients are served each day. She said some veterans from the area around St. James, Minnesota, sometimes prefer the Spirit Lake clinic because it falls under the umbrella of the Sioux Falls VA, rather than the Minneapolis VA. King was pleased to hear there is a clinic within 60 miles of a large majority of veterans — a goal he said the legislature had worked on for years.

“This one is so well positioned to address that particular formula,” King said.

Of the thousands of veterans seen at the Spirit Lake Clinic, Cook estimated only 75 to 85 are women. But she said the numbers aren’t quite what they seem. She said WWII veterans are becoming more and more rare, while Korean and Vietnam vets are becoming the more common demographic.

“But after them, you kind of have this gap,” Cook said. “What I’ve noticed in the private sector is, when I talk to those that are in the 30- to 40-year-old range, they have health insurance, and they just have not needed the VA.”

King said he foresees the number of women served at VAs across the country increasing as veterans of more modern conflicts age. Sara Ackert, director of the Sioux Falls Medical Center, agreed with King’s prediction.

“They’re our fastest growing population percentage-wise,” she said. “It’s just that the numbers are still small.”

Nationally, the VA has directed clinics to include women’s health facilities, according to Cook. The Spirit Lake clinic already meets that directive.

“We take pride in being able to serve them just as fully as the male population, which is a change in thinking from the old days,” Cook said. “It’s definitely important.”

King said it’s also important for the government to keep the promises made to veterans.

“Whatever the deal is, that’s what we live by,” King said. “It helps the world be orderly, and organized and keeps people accountable.”

He said Congress has passed several items to address problems in the VA system at the federal level.

“It was structured in such a way that you couldn’t fire people who weren’t doing their job,” King said. “It’s pretty clear we have a president now that one of his past career successes was doing exactly that — removing people that need to be removed.”

He said the process can be frustrating and the intent of some legislation can be warped to a degree during the rule-making phase.

With the possibility of U.S. Rep. Nancy Pelosi retaking the role of Speaker of the House, King was unsure what legislative changes may lie ahead concerning veterans. He said Pelosi’s 2007 speakership coupled with Barack Obama’s presidency two years later made it difficult for him to advance bills.

“That was a time when anything I would bring would be killed off by her gavel or Barack Obama’s veto pad, so that stalled a lot of things that I wanted to get done,” King said. “We’ve only had a two-year window here to move an agenda. Some of the folks weren’t as aggressive as I would have liked to have been, but now we’re playing defense, so we shall see.”

But, overall, King said progress at the VA has been a bright spot.

“I think the process is going in the right direction at the top of the VA,” King said. “I’d like to see everybody all across the United States of America have the same kind of care that we provide our veterans here in Spirit Lake.”